Of the 1.7 million breast cancer survivors in the US, it is estimated that 70% will report that cancer impacted their lives in a positive manner, despite the negative aspects of diagnosis and treatment. In spite of the NCI's Office of Survivorship's call for studies to investigate long-term positive effects of cancer, we still know very little about this phenomenon. This new investigator small grant application (R03) focuses on patients' perceptions that having breast cancer led to positive life changes (Benefit-Finding and Growth; BFG). Women commonly report that cancer was a transformative experience that has challenged them to find a new sense of purpose in life and has enhanced their functioning across a number of domains. To date, no study has systematically examined the long-term pattern of development and maintenance of BFG in these individuals. In fact, there is little understanding of the factors that promote positive adjustment to breast cancer past the immediate diagnosis and treatment phase. We conducted follow-up assessments with over 200 participants in an NCI-funded stress management intervention study. All women had early stage breast cancer and were assessed within 8 weeks of surgery, 3-months post-surgery (corresponding to post-intervention follow-up), 6-month, 12-month and 5-year follow-ups (considered long-term survivors). Using structural equation modeling and latent growth curve modeling, we will examine BFG as women navigate the sometimes rocky terrain of the cancer experience from the time of surgery to long-term survivorship. By the end of this project, we will be able to answer pertinent questions regarding how BFG changes over time, which people will derive positive meaning from their experience, and what characteristics predict such changes (e.g., sociodemographic variables, disease-related variables, and psychosocial characteristics: coping, optimism, social support, emotional processing). Empirical tests of critical aspects of the theory of the development and maintenance of BFG will be conducted. We will also understand BFG's relation to traditional endpoints (Physical: fatigue, physical functioning, health status, and subsequent cancer events/recurrence; Psychological: quality of life, distress; Economic: Return to Work/Employment), and determine how a stress management intervention can influence positive adjustment in the five years post-surgery for breast cancer.